Cutaneous primary paracoccidioidomycosis

Abstract

Paracoccidioidomycosis is a common fungal infection in Latin America. Few cases have been described in non-endemic countries and their diagnosis without the correct suspicion, bearing in mind that the latency period might be up to 60 years, may not be easy. We report the case of a 59-year-old man who worked as a taxi driver for 25 years in Venezuela. Cutaneous paracoccidioidomycosis was diagnosed one year after he returned to Spain. No internal signs or symptoms of the disease were found and cell-mediated immunity showed no depression. Our case suggested us to consider direct cutaneous infection, although respiratory tract is believed to be the most frequent portal of entry for this infection.

Sarcoid-like paracoccidioidomycosis: case report

“…Few cases of primary accidental or traumatic cutaneous location of the infection have previously been described. 7 Most primary cutaneous lesions had small scratches or cuts before the infection. 7 Reviews of cutaneous manifestations in paracoccidioidomycosis have shown that the infiltrative pattern corresponded to up to 26.6% of the skin lesions observed, which included the sarcoidosis-like lesions.…”

“…7 Most primary cutaneous lesions had small scratches or cuts before the infection. 7 Reviews of cutaneous manifestations in paracoccidioidomycosis have shown that the infiltrative pattern corresponded to up to 26.6% of the skin lesions observed, which included the sarcoidosis-like lesions. 8 According to Marques et al, patients of any age presenting PCM with sarcoidosis-like clinical pattern have few and indolent lesions, as occurred in the patient described in this report, probably as consequence of certain equilibrium between the agent and the host defense.…”

Skin Infections

“…132 The acute/subacute form usually affects children, teenagers, and young adults and is also called "juvenile type." 545,546 Paracoccidioidomycosis in AIDS patients usually manifests in a form similar to severe acute/subacute cases; however, the incidence of coinfected individuals is low. 543 On the other hand, lung and mucosal lesions are rare.…”

Paracoccidioidomicosis con afectación mucocutánea. Reporte de un caso

“…Esta enfermedad es endémica en ciertos países del sur y de centroamérica con la más alta prevalencia observada en Brasil (aproximadamente 80%) 2 . En el Perú el reporte de esta enfermedad no es obligatorio, por lo cual, no se tiene datos exactos de su prevalencia, solo el reporte de casos ha permitido conocer la distribución geográfica en zonas tropicales de la ceja de selva y selva baja amazónica 3,4 . Esto constituye una escasa cobertura en el diagnóstico y por ende un retraso en el tratamiento, lo que impide mejorar el pronóstico de esta enfermedad.…”

“…Se utilizan tinciones especiales con PAS o a la metenamina de plata de Grocott-Gomoni, con el objetivo de mejorar la observación del hongo 3 . Además, las técnicas de biología molecular como la reacción en cadena de la polimerasa (PCR) demuestran una alta sensibilidad adecuada para el diagnóstico y el seguimiento del tratamiento 4,5 .…”